When I attended the Natural Products Expo this year I noticed that there were dozens of newly launched products that were fortified with probiotics – they were everywhere! There is no disputing that probiotics (good bacteria) are good for you, but I have to question the viability of the probiotics in these products and whether they are any better than eating naturally fermented foods. I try to add fermented foods to my diet often and I eat them almost every day because I’ve found them to be the best way to feed my body probiotics.
This is essential because most of our food has been pasteurized, irradiated, or chemically treated to kill bugs – but this also kills the good stuff. Our soil is depleted of good bacteria with the overuse of synthetic pesticides and other chemical contamination. Certain substances in our food have also been suspected to cause leaky gut syndrome – which creates tiny little holes in our digestive system organs that leak out the good bacteria we need to stay healthy and keep our immune system strong.
This is why we absolutely must do everything to restore the good bacteria in our guts. Historically, food was often preserved with fermentation and traditional diets often consisted of raw and fermented foods that contained a healthy dose of good bacteria. The fermentation process creates good bacteria that work like a little army in your gut helping to defend you from various ailments.
Besides eating fermented foods regularly, I also take a probiotic supplement. I like to take one as insurance, just to make sure that my body is getting all of the healthy probiotics that it needs. This is also super important when traveling, when fermented foods may not be as easy to come by and at least I know that I’ve got a probiotic pill as a backup.
That being said, not all probiotic supplements are created equally. Some on the market have been shown to have inaccurate labeling and may not contain all of the probiotics that they say they do. To gain more information on this, I reached out to Dr. Amy Shah, M.D., a member of my advisory council, and asked her to compile her research into a guest post for us. Dr. Shah is a practicing physician, specializing in Allergy & Immunology and Internal Medicine. The following is what she has to say about probiotic pills, how to choose the best supplements, plus a simple test that you can do at home to test your probiotics to see if they are viable!
Here’s some news: your probiotic pill is probably not doing anything for you.
I know that’s a bold statement but it’s true.
First, probiotic pills are under regulated – meaning no one is really making sure that what you see is actually what you get. I will explain more below.
Secondly, the studies supporting probiotics are weak. For all intents and purposes a probiotic study just has to show that its strain of probiotic comes out in the stool after you ingest it. Does that mean it did anything for you while it was traveling down your intestines? No.
Lastly, food based probiotics (fermented foods etc) seem to be a more potent and effective way to reseed the gut. In other words, why use pills when there are countless, delicious fermented food options out there?
But listen – if you are going to take probiotics then I recommend some that are MUCH better than others.
1. Did you know that PROBIOTICS ARE HUGELY UNDER-REGULATED?
Currently probiotic manufacturers do not have to specify on their product labels the strains they use in probiotic products or specify the number of live microbes of each strain deliver though the end of shelf life. So even an expiration date is not mandatory!
Additionally, probiotics fall into multiple categories within FDA regulations (food, food additive, supplement and drug) so “expertise is spread unevenly across multiple centers at FDA without a single authoritative agency voice on the issue”.
So probiotics operate in an unregulated marketplace. Label claims are often inaccurate, as is the amount of bacteria the probiotics are said to contain. In fact, it’s nearly impossible to know just what you’re getting. One study tested 14 commercial probiotics and found that only one contained the exact species listed on the label.
If you are buying probiotics from your local drug store shelf chances are you are buying nothing more than fluff.
Considering probiotics are delicate live bacteria – they can die during high heat processing, during the packaging process, or while living on the shelves of the store.
2. Did you know that the STUDIES supporting most Probiotics are weak?
There are gaps in current research, concerns about quality of research, and ethical and consumer issues related to under-regulated, under-enforced product claims.
A probiotic pill or product is not technically a probiotic unless the bacteria have been shown to be viable when ingested so most probiotics out there are not actually probiotics.
Even the American Academy of Microbiology has said that “at present, the quality of probiotics available to consumers in food products around the world is unreliable.”
Another issue is that the probiotic listed in the ingredients may not “seed” your gut meaning you are just taking it and then pooping it out. Think of a seed that is planted in a barren garden – you can plant the seeds but they won’t grow without water and sunlight. Similarly, probiotics cannot proliferate and live in your gut if you take a probiotic pill but then don’t eat foods that support its growth.
There are tons of probiotics out there and many with accompanying studies that support their efficacy – but ultimately, most probiotic supplements are bogus and a waste of your money.
3. Food-based Probiotics are preferred.
You can effectively reap the benefits of probiotics by drinking kombucha or coconut kefir, which you can actually make yourself with kefir grains. If that sounds like too big an undertaking, choose an organic low sugar kombucha from your health food store.
Probiotic – or fermented – foods provide a great amount of nutrients and phytochemicals. Sauerkraut and fermented vegetables are SUPER easy (and cheap!) to make yourself. Literally get a jar, add water, salt, veggies, cover – put in a cupboard for 3-10 days. Poof! Probiotics.
There are also prebiotic foods – foods that gut bacteria eat and need to proliferate. Chicory root, artichoke, dandelion greens, asparagus are all good prebiotic options. The key here is to get fiber all the way to the good bacteria that live in the last parts of our colon.
However, if you’re unable to take in these foods, you can get some of the needed nutrients from a supplement.
If you do decide to take pills:
I personally use a brand called VSL-3 (non-GMO) containing 112.5 billion bacteria per capsule. The dried sachet form has level I evidence of effectiveness (highest level possible for medical studies) in treating Crohn’s and other inflammatory bowel diseases.
Make sure to take the recommended dosage and to take the supplement on an empty stomach first thing in the morning and before bed. Look for a probiotic with an expiration date and one that contains a wide range of bacteria strains, most importantly:
- Acidophilus: Naturally found in mouth, intestine and vagina (often prescribed for yeast infections). Promotes nutrient absorption and facilitates dairy digestion.
- Longum: Anti-inflammatory, protects gut lining, keep toxins and pathogens out of the gut.
- Bifidum: Found in small and large intestines. Necessary for optimal digestion within digestive tract.
The jury is out as to if refrigerated probiotics are necessarily “better” but for sure refrigerate them once opened.
Home test: You can test probiotic supplements at home by adding them to about 4 oz of cold milk and leaving them for 24-48 hours to see if it reacts with the milk. If it curdles, or becomes a yogurt like consistency – then it’s viable.
Another test is checking your stool for bacteria before and after taking a supplement or changing your diet. Companies like Ubiome are doing this.
So, there it is – do you take probiotics? Why or why not?
Dr. Amy Shah is a specialist in Allergy & Immunology and Internal Medicine. She pursued her medical training at Columbia University Medical Center, Beth Israel Deaconness/Harvard Medical School, Albert Einstein College of Medicine, and Cornell University. Prior to graduating with honors in research, she worked in the Channing Laboratory at Harvard University looking at the health effects of heavy metals on the body. She is now in a private medical practice. To learn more about Dr. Shah, visit amyshahmd.com.